Regular paperBaseline characteristics, management practices, and in-hospital outcomes of patients hospitalized with acute coronary syndromes in the Global Registry of Acute Coronary Events (GRACE)*☆,
Section snippets
Methods
Full details of the GRACE rationale and methods have been previously published1 and are outlined briefly as follows. A total of 95 hospitals organized into 18 clusters in 14 countries in North and South America, Europe, Australia, and New Zealand are currently collaborating in GRACE. Clusters were chosen based on local demographic characteristics and hospital facilities to ensure a representative sample of patients with ACS from each country and hospital systems of different sizes and treatment
Results
Enrollment in GRACE started in April 1999 and involved 95 institutions (Table 1). At admission, patients were assigned a working diagnosis of myocardial infarction, unstable angina, rule-out myocardial infarction, or chest pain. The present study includes a total of 11,543 patients enrolled by the end of December 31, 2000. Using the prespecified diagnostic criteria described previously, cases were subsequently divided into those with STEMI (30%), NSTEMI (25%), unstable angina (38%), or other
Discussion
The management of ACS has been well defined by clinical trials and summarized in reviews4, 5 and guidelines.6, 7, 8, 9 However, “real life” patient populations sometimes differ markedly from those in clinical trials.10 In addition, there is considerable heterogeneity in patient management practices.11 Therefore, large-scale observational data sets, such as GRACE, are important to complement the information obtained via randomized clinical trials.
One potential value of registry data is the
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GRACE is supported by an unrestricted educational grant from Aventis Pharma, Bridgewater, New Jersey.
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Further information about the project, along with a complete list of the study participants, can be found at www.outcomes.org/grace.